SERVICE LIST AND PRICING: - Temple Beth Ami



Since 1987 Temple Beth Ami (TBA) has been the center of Jewish life in Santa Clarita. TBA was founded to serve the spiritual needs of the Jewish community, here in the Santa Clarita Valley, and we are dedicated to the dual pillars of compassion and outreach. For those that can contribute towards the future growth and sustainability of TBA, we encourage and appreciate your discretionary “Foundation” contribution. For those who wish to be members but may have financial hardship, please contact us for information regarding membership dues assistance. We want to emphasize that each and every member is a valued part of TBA’s sacred community. This agreement refers to the fiscal year - July 1, 2017 to June 30, 2018.Contribution Levels Foundation$5,000Family $2,213Individuals 18-29.................................................................... $87230-64...................................................................$122065+........................................................................$872CouplesEmpty Nesters.....................................................$1358Senior Couple$1120MembershipI hereby apply for membership at Temple Beth Ami, Santa Clarita, CA. To ensure the continued Jewish presence in Santa Clarita, I commit that my annual contribution for this year is:__________________________$_______________Contribution LevelMembership DuesYour annual membership contribution includes High Holiday tickets for your immediate familySchool Fee Schedule per childAnnual Tuition FeeGrades K through 3 $650Hebrew School Judaica (Sundays) $750Hebrew School Hebrew Grade 4, 5 and 6 $550Hebrew School Grade 7 /Bar/Bat Mitzvah Prep $600 School fees are non refundableBar/Bat Mitzvah tutoring and fees additionalParents of Bar/Bat Mitzvah candidates must be members in good standing. School FeesI hereby request my child be enrolled for formal education courses at Temple Beth Ami, Santa Clarita, CA. __________________________ $________________ Grade(s) Being EnrolledTotal School FeesPlease complete for each child being enrolled:Child 1Child 2Child 3Child 4Last NameFirst NameHebrew Name (in English)Birth Date | AgeGender (F / M) | GradeSpecial Educational NeedsBar/Bat Mitzvah YearPayment Options: FACTS Secure web-based automatic monthly payment Pay in full by check or credit card Invoice (includes service fee $10 per payment)Visa, MastercardName: ______________________________________________ Card #__________________________Please printCVC ____________Exp____________Signature: ______________________________________________ Date: _______________Adult 1:_____________________________________________________________________________________First/Last NameDaytime # Best time to callEmail addressAdult 2:_____________________________________________________________________________________First/Last NameDaytime # Best time to callEmail addressFor Adult 1 and Adult 2; check the items you are interested in: 1 2 1 21 2 Adult Bar/Bat MitzvahCommunity SederSenior LivingAdult ChoirFamily PromiseShabbat/HavdalahAdult EducationLGBTQ SisterhoodChavurahMen's ClubSportsChildren's High Holiday ProgMommy and MeTeen Group Other:_______________________________________________________________________ Other:_______________________________________________________________________I want to share my expertise in the following areas:1 2 1 2 1 2AccountingGrant Writing PhotographyCarpenter/HandypersonGraphic ArtsPublic RelationsComputer Skills/WebLegalSocial MediaEntertainmentLeadership DevelopmentTeaching Hebrew Fundraising Marketing Teaching Judaica Other:_______________________________________________________________________ Other:_______________________________________________________________________I like to help, just call me! Date:____________________Family Name:Marital Status of Adult Member(s)_____ Married Anniversary Date: _____________________________ Single _____ Life Partners ____ Divorced ____ WidowedHome Phone:Emergency Contact No:Home Address:Billing Address if not home address: City:Zip code:City / State for Billing address:Zip code:Adult Member 1Last Name: _______________________________________________First Name: _______________________________________________Hebrew Name (in English) ___________________________________Birth Date: Month _______ Day ______ Year ______ Age: ______Faith: Jewish _______ Other: _______________________________Office Ph: _____________________ Cell Ph: ___________________E-Mail: __________________________________________________Occupation or Title (if employed): _____________________________Employer: ________________________________________________Adult Member 2Last Name: ________________________________________________First Name: ________________________________________________Hebrew Name (in English) ____________________________________Birth Date: Month ______ Day ________ Year _______ Age: _____Faith: Jewish _______ Other: ________________________________Office Ph: _____________________ Cell Ph: ____________________E-Mail: ___________________________________________________Occupation or Title (if employed): ______________________________Employer: _________________________________________________YAHRZEITS (commemoration of a death of parent, sibling, spouse, child)Family Member Name RelationshipDate of Death (Secular) MM/DD/YYYYPlease attach additional pages if necessary.PROFESSIONAL BUSINESS DIRECTORY (Please include my business/trade in the professional business directory )Business/Professional Name To be listed in the directory Type of Business/Service/GoodsContact Information You Would Like Listed (e.g., email; phone number, address) Exclude my name and address from the Member Directory. The directory is only available to synagogue members. Exclude my email from Temple Communications. Note that email is an important communication vehicle for the Temple, ONLY check this box if you do NOT want to receive the eBlast or online newsletter. ................
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